Military history and the American Civil War

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The statistics of those who died during the Civil War, not from injury but from disease, are shocking. Of the 360,222 men known to have died on the Union side, a quarter of a million were lost due to disease rather than the enemy. While the Confederates didn’t keep records, it is estimated that seventy-five percent of the 258,000 Southern deaths could be attributed to disease.

For many, the cycle of illness started soon after joining up. Those from the less populated countryside found themselves in large groups after mustering in – perhaps for the first time in their lives – and were exposed to childhood maladies like the measles, mumps and smallpox. Confederate soldier William A. Fletcher’s experience appears to be not uncommon. A young man from Texas who first signed on in 1861 as a member of the 5th Texas Infantry of Hood’s brigade, he wrote in his memoirs that in the first large camp he was assigned to after signing up, he contracted the measles. While in the hospital recovering from an associated extremely high fever, he became infested with lice and before being released, he contracted the mumps.

In this camp we suffered a good deal with sickness—the most fatal I guess was measles. I had an attack of measles and was sent to the hospital in Richmond and remained there a few days and got tired of hospital life, so I tried to be a good boy and please the woman who had charge of the ward in which I was. I soon persuaded her to get me a discharge, and I returned to camp one cold, frosty morning; the next day I was hauled back a very sick man; was put in a small room that had a coal grate and was instructed to stay in bed and keep well covered up. I lay there a few days with a burning fever, taking such medicine as was prescribed. I had learned the “itch” [from lice] was getting to be a common complaint in the hospital, and after the fever had somewhat abated, I found I had it, so when the doctor made his next visit I drew my arms from under the covers and showed him the whelps or long red marks of itch, and he said he would send me some medicine that would cure it. [i]

While encamped near Fredericksburg, Fletcher suffered from a severe attack of jaundice and was given a permit of sick leave. Rather than moving with his unit, he took a room in a Fredericksburg hotel where he received no medical care and almost died of food poisoning. [ii] Cases like this – and worse – were common due to a lack of sanitary conditions, adequate food, clean water and trained medical care. Gerald Linderman confirms that “each army suffered two waves of disease,” the first being “acute infections of childhood.” [iii] Because those who survived the first wave developed immunities, the incidence abated over time. But it was followed by a second wave that decimated the ranks in ever increasing numbers. Considered “camp” diseases, dysentery, malaria, and diarrhea, took men in their tents and in hospitals by the thousands, reducing the effective fighting force of many units dramatically. [iv]

John D. Billings, in his memoir Hard Tack and Coffee, brought up two important points about health in army camps. The first was that many men came to the army already ill. This was particularly true of the recruits in 1864 and 1865, “for those who have occasion to remember will agree that a sufficient number of men too old or diseased came to the front in those years – no, they did not all get as far as the front – to fairly stock all the hospitals in the country.” [v] Billings attributed this to both the incompetence of some of the doctors providing physical examinations for enlisting recruits and the desperation of the government willing to use marginal physicians and accept men clearly unfit for duty.

Billings also spoke of the presence in every company of men who feigned illness to escape duty. As might be expected, these men were seen as shirkers who burdened others in the company with the work they did not perform. These “beats on the government” showed up routinely at the sick tent to receive the care and, in some cases, medicine administered by the doctor. Quinine was the drug du jour “whether for stomach or bowels, headache or toothache, for a cough or for lameness, rheumatism or fever and ague.” [vi] Some who feigned illness went so far as to refuse food and so created a real health crisis for themselves with varying consequences ranging from transfer to a hospital and eventual release from the service, to susceptibility to more severe and long term conditions. [vii]

The fact remains that many, many men died of very real and unwanted maladies. Diseases flourished in camp because of poor nutrition, inadequate sewage disposal, dirty water and infrequent bathing. Typhoid, measles, cholera and dysentery killed hundreds. Even General Lee contracted dysentery on his way to Gettysburg. Billings spoke eloquently of his many friends who suffered and died of wasting illnesses, either in the field or in hospitals, away from the families who could have unquestionably cared for them better at home. [viii]

As James I. Robertson, Jr. pointed out in his book, Soldiers Blue and Gray, “more confederates died of illness during the seven week aftermath at Corinth than fell in the two days of intense fighting at Shiloh,” an aftermath not at all uncommon during the war and certainly after every battle. [ix]

The statistics of those who died during the Civil War, not from injury but from disease, are shocking. Of the 360,222 men known to have died on the Union side, a quarter of a million were lost due to disease rather than the enemy. While the Confederates didn’t keep records, it is estimated that seventy-five percent of the 258,000 Southern deaths could be attributed to disease.[i]

I found fascinating that for many, the cycle of illness started soon after joining up. Those from the less populated countryside found themselves in large groups after mustering in – perhaps for the first time in the lives – and were exposed to childhood maladies like the measles, mumps and smallpox. Confederate soldier William A. Fletcher’s experience appears to be not uncommon. A young man from Texas who first signed on in 1861 as a member of the 5th Texas Infantry of Hood’s (see Hood’s photo right) Brigade, he wrote in his memoirs that in the first large camp he was assigned to after signing up, he contracted the measles. While in the hospital recovering from an associated extremely high fever, he became infested with lice and before being released, he contracted the mumps.

In this camp we suffered a good deal with sickness—the most fatal I guess was measles. I had an attack of measles and was sent to the hospital in Richmond and remained there a few days and got tired of hospital life, so I tried to be a good boy and please the woman who had charge of the ward in which I was. I soon persuaded her to get me a discharge, and I returned to camp one cold, frosty morning; the next day I was hauled back a very sick man; was put in a small room that had a coal grate and was instructed to stay in bed and keep well covered up. I lay there a few days with a burning fever, taking such medicine as was prescribed. I had learned the “itch” [from lice] was getting to be a common complaint in the hospital, and after the fever had somewhat abated, I found I had it, so when the doctor made his next visit I drew my arms from under the covers and showed him the whelps or long red marks of itch, and he said he would send me some medicine that would cure it.[ii]

While encamped near Fredericksburg, Fletcher suffered from a severe attack of jaundice and was given a permit of sick leave. Rather than moving with his unit, he took a room in a Fredericksburg hotel where he received no medical care and almost died of food poisoning.[iii]

Cases like this – and worse – were common due to a lack of sanitary conditions, adequate food, clean water and trained medical care. Gerald Linderman confirms that “each army suffered two waves of disease,” the first being “acute infections of childhood.”[iv] Because those who survived the first wave developed immunities, the incidence abated over time. But it was followed by a second wave that decimated the ranks in ever increasing numbers. Considered “camp” diseases, dysentery, malaria, and diarrhea, took men in their tents and in hospitals by the thousands, reducing the effective fighting force of many units dramatically.[v]

John D. Billings, in his memoir Hard Tack and Coffee, brought up two important points about health in army camps. The first was that many men came to the army already ill. This was particularly true of the recruits in 1864 and 1865, “for those who have occasion to remember will agree that a sufficient number of men too old or diseased came to the front in those years – no, they did not all get as far as the front – to fairly stock all the hospitals in the country.”vi] Billings attributed this to both the incompetence of some of the doctors providing physical examinations for enlisting recruits and the desperation of the government willing to use marginal physicians and accept men clearly unfit for duty.

Billings also spoke of the presence in every company of men who feigned illness to escape duty. As might be expected, these men were seen as shirkers who burdened others in the company with the work they did not perform. These “beats on the government” showed up routinely at the sick tent to receive the care and, in some cases, medicine administered by the doctor. Quinine was the drug du jour “whether for stomach or bowels, headache or toothache, for a cough or for lameness, rheumatism or fever and ague.”[vii] Some who feigned illness went so far as to refuse food and so created a real health crisis for themselves with varying consequences ranging from transfer to a hospital and eventual release from the service, to susceptibility to more severe and long term conditions.[viii]

The fact remains that many, many men died of very real and unwanted maladies. Diseases flourished in camp because of poor nutrition, inadequate sewage disposal, dirty water and infrequent bathing. Typhoid, measles, cholera and ddysentery killed hundreds. Even General Lee contracted dysentery on his way to Gettysburg.[ix] Billings spoke eloquently of his many friends who suffered and died of wasting illnesses, either in the field or in hospitals, away from the families who could have unquestionably cared for them better at home.[x]

As James I. Robertson, Jr. pointed out in his book, Soldiers Blue and Gray, “more confederates died of illness during the seven week aftermath at Corinth than fell in the two days of intense fighting at Shiloh, an aftermath not at all uncommon during the war and certainly after every battle.[xi] Disease was – without question – the war’s biggest killer.